Monthly Archives: June 2018

Migrate from CareSync to HealthViewX

Important information for CareSync clients

Migrate seamlessly and effectively from CareSync to HealthViewX Chronic Care Management Solution.

Safe, seamless and rapid migration to HealthViewX can be completed in just four quick steps. Our team of technical and functional experts will assist you in every step below.

  1. Provide HVX with the required access to the CareSync data
  2. HealthViewX mapper will automatically map the CareSync data and make it compatible to use immediately
  3. Import data and set up user accounts on HealthViewX
  4. Continue CCM service from where you left it

What is HealthViewX?

The HealthViewX end-to-end Care Orchestration Platform guides healthcare organizations through its entire care journey by

  • Enabling data-driven decision support and
  • Providing real-time insights of patient-reported data to promote better care delivery.

The platform enables secure communication of patient information and remote monitoring of patient vitals to improve participation and create an interoperable ecosystem for care delivery. The API friendly, cloud-hosted HealthViewX is architected to help piece together disparate sources of patient information like various EMR and EHR systems without compromising on security.

Unique Features:

  1. Automate CCM documentation process with HealthViewX web-based Chronic Care Solution
  2. HealthViewX CCM solution is secure. HIPAA Compliant Platform hosted in cloud server with in-built features lets you define the access and also have user-specific access conditions.
  3. Create condition specific and comprehensive care plan for each patient for better care coordination. Simplify and streamline workflow to guide telenurses in creating a care plan.
  4. Hosted in cloud servers, HealthViewX CCM solution is extremely scalable to meet the requirements of any operative size and our pay-per-user pricing model keeps overhead cost minimal and manageable.
  5. The dashboard gives detailed actionable insights for better care coordination with patients.

With a secure, fast and seamless transition to HealthViewX, you will be able to continue offering chronic care management services effectively. Our team of experts is concerned about this sudden and brief disruption and guarantees you a smooth transition from CareSync to HealthViewX.

Outsourcing Chronic Care Management In 2019 – Associated Benefits And Risks

Medicare has offered reimbursements to physicians for Chronic Care Management services since 2015. But still, providers are struggling with patient engagement, education, efficient processes and regulatory compliance.

CCM provider provides 20 minutes of monthly non-face-to-face care management services for beneficiaries with two or more chronic conditions. It helps in managing their conditions, risk factors, medication adherence, and coordination of care with other providers. To bill for CCM services, practices must offer

  • 24/7 access to care management services
  • a platform for direct patient-practitioner communication
  • ability to manage transitions between providers and settings

Why are hospitals outsourcing CCM services?

CCM program is a labor-intensive process. It requires

  • Recruitment and training certified staff
  • EHR systems to track care plans
  • Monitor and document monthly calls
  • Making staff available to patients 24/7
  • More office space

In order to avoid these challenges, hospitals are outsourcing CCM services.

Advantages of outsourcing CCM services

  1. New significant revenue stream – A small hospital cannot afford costly EHRs, handle staff-patient management, etc. These aspects are important for chronic care management implementation. Hence they are outsourcing CCM services. The outsourcing agencies specialize in CCM services and take a part of the profit from the practice. It generates a new significant revenue stream for practices who otherwise cannot get Medicare CCM reimbursements.
  2. Saves physician’s time and effort – Outsourcing CCM services overcome the time-intensive CCM challenge for many physicians. Many of them do not have the professional staff bandwidth to provide the continuous chronic care management services. The new CMS initiative of paying doctors for CCM services works well with outsourcing.
  3. Better patient satisfaction– The billing physician creates a specific healthcare plan for his patients. The physician then turns that plan over to the CCM vendor who is responsible for the daily or weekly contact with the patient. The CCM vendor monitors the patient’s progress and provides health coaching according to the physician’s care plan. The vendors must make sure that the patient is adhering to the plan and keep the physician posted. This allows the physician to extend his chronic care management to more patients with the required staff bandwidth.
  4. Improved patient interaction – Outsourced services can combine technology, clinical services, and analytics with minimal efforts from the physician’s end. It results in improved patient interactions between actual office visits, with no impact on their current professional staff.
  5. Increased patient enrollment – Outsourcing CCM will allow the physician to
  • increase and maximize patient enrollment in the program
  • improve patient compliance
  • provide CCM documentation requirements

    while minimizing the physician’s workload.

Risks of outsourcing CCM services

1. Risk Management – Outsourcing CCM may sound easy on the front end, but it is very hard to mitigate the risks on the back end. Medicare fraud violations cost up to $10,000 per incident and may even subject the physician to a jail term. Outsourced CCM services make the practice actively and directly responsible for multiple risk factors:

  • Is the person performing the work appropriately credentialed to work in the state (especially nursing-staffed call centers)? Has the practice taken active steps to confirm this is?
  • Are all of the services billed for on the claims actually performed? Is the practice actively performing spot checks to ensure same?
  • Is the practice periodically checking that the documentation they receive for these claims and services is actually legitimate?
  • Is patient’ privacy taken care of? It is HIPAA-compliant?
  • Is the practice provided audit logs to protect them if they are audited? How often do they receive audit logs?

Never forget that an outsourced CCM vendor is paid on the volume while you hold 100% of the risk. At a minimum, this creates misaligned incentives and requires the practice’s perpetual and diligent oversight.

2. Profit factor – CCM vendors may take from half up to two-thirds of the CCM reimbursement for complete outsourced CCM service. When the added expenses are taken out of the payment, a practice may get only $7 to $12 per patient. In addition to paying the third party, it also has the labor cost of

  • Filing the claim
  • Paying the clearinghouse and the biller
  • Collecting $8 copay.
  • At one point, there is no profit from outsourced services

3. Patient’s experience – When a practice outsources the CCM services, the CCM vendor takes care of following up with the patients. Every time a patient gets a call, the person calling for rendering CCM service is unknown to them. The patients are not happy with different people calling them up every month. The vendors will not be fully aware of the patient’s medical history resulting in an average CCM call. The patient will also not feel good about talking to random people every month. Patients become dissatisfied with the outsources CCM services and leave the network.

4. Losing continuity with patients – In outsourced CCM, the practice does not get in touch with their patients regularly. When the patient visits the hospital, the physician will have to go through the previous CCM service history. It is better for the practice to do CCM services rather than give it to a CCM vendor. It affects the practice’s patient network and results in revenue loss.

Outsourced CCM services have a  mix of advantages and risks. HealthViewX Chronic Care Management solution supports outsourced CCM as well as CCM services provided directly by the practice. The risk factor associated with outsourcing CCM is minimal in HealthViewX Chronic Care Management software.

HealthViewX Chronic Care Management solution features

HealthViewX Chronic Care Management solution has the following features that make the process simpler,

  • Inbuilt audio, video calling and messaging features – HealthViewX Chronic Care Management solution has inbuilt video and audio calling features. It helps in giving Chronic Care Management services to their patients. Secure messaging is also available through which the physicians and the patients can communicate.
  • Automated call log feature – After a call, care plan creation or any action related to CCM health services, the system automatically adds call logs. It reduces the physician’s manual effort is logging the call logs.
  • Preventive Care plans – HealthViewX solution supports care plans for the Chronic Care Management service for a patient. The physician can create a care plan depending on the patient’s health report. It helps in monitoring the patient’s vitals.
  • Chronic Care Management Analytics – Dashboards with intuitive charts and tables give complete analytics of the Chronic Care Management services. It provides a clear picture of the revenue perspective.
  • Consolidated Report – The physician can generate a consolidated report of the Chronic Care Management services given for a particular period. This makes it easy for the billing practitioner for getting the reimbursements.
  • HIPAA compliance – HealthViewX Chronic Care Management is HIPAA-compliant. It facilitates secure data exchange. The solution manages all patient-related documents securely.

HealthViewX Chronic Care Management solution has features that suit practices as well as CCM vendors. To know more about our Chronic Care Management solution, schedule a demo with us.

 

References

http://www.federalcharges.com/medicare-fraud-charges-penalties/

What is Complex Chronic Care Management – All you need to know

Chronic Care  Management

The Centers for Medicare & Medicaid Services (CMS) considers Chronic Care Management (CCM) as a crucial part of primary care. Chronic Care Management is non-face-to-face care provided to Medicare patients with two or more chronic conditions. It contributes to better health services to people. In 2015, Medicare started to reimburse a certain amount for the Chronic Care Management services under the Medicare Physician Fee Schedule (PFS).

Service Codes

  • CPT 99487 – Complex chronic care management services with the following required elements:
    • Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient
    • Chronic conditions place the patient at significant risk of death, acute exacerbation, or functional decline
    • Establishment or substantial revision of a comprehensive care plan
    • Moderate or high complexity medical decision-making
    • 60 minutes of clinical staff time directed by a physician or other qualified care provider, per calendar month
  • CPT 99489 – Each additional 30 minutes of clinical staff time directed by a physician or other qualified      care provider, per calendar month (List separately in addition to code for primary procedure)

Difference Between CCM and Complex CCM

CCM (“non-complex” CCM) and complex CCM services have similar health service elements. They differ in the following aspects,

  • Amount of clinical staff service time provided
  • Involvement and work of the billing practitioner
  • The extent of care planning performed

According to Medicare, “Complex Chronic Care Management services of less than 60 minutes in duration, in a calendar month, are not reported separately. Practitioners must report CPT 99489 in conjunction with CPT 99487. They must not report CPT 99489 for care management services of less than 30 minutes along with the first 60 minutes of Complex Chronic Care Management services during a calendar month.”

Eligibility Criteria for Care Providers

Physicians and the following non-physician practitioners may bill CCM services:

  • Certified Nurse Midwives
  • Clinical Nurse Specialists
  • Nurse Practitioners
  • Physician Assistants

Patient Eligibility

Medicare provides Chronic Care Management services for patients with multiple (two or more) chronic conditions

  • Expected to last at least 12 months or until the death of the patient
  • Places the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline

As Chronic Care Management services have reimbursements, physicians must consider administering CCM to the eligible Medicare patients. The billing practitioner cannot report both complex and regular (non-complex) CCM for a given patient for a given calendar month. In other words, a given patient receives either complex or non-complex Chronic Care Management services during a given service period, not both.

Supervision

The Complex CCM codes (CPT 99487, 99489) come under the general supervision according to Medicare PFS. A billing practitioner need not give the health service personally. Any qualified care provider can give the service under the billing practitioner’s overall direction and control. The billing practitioner’s physical presence is not required.

CCM Service Summary

Care providers give a non-complex or complex Chronic Care Management service through the following steps,

  1. Initiating Visit – Medicare requires initiation of CCM services for new patients or patients not seen within one year of commencement of CCM. It is a face-to-face visit with the billing practitioner. It includes an Annual Wellness Visit [AWV] or Initial Preventive Physical Exam [IPPE], or other face-to-face visits. This initiating visit is not part of the CCM service and is separately billed.           
  2. Structured Recording of Patient Information Using Certified EHR Technology –  Structured recording of patient’s demographics, problems, medications, and medication allergies using certified Electronic Health Record (EHR) technology.
  3. Comprehensive Care Plan – A person-centered, electronic care plan based on a physical, mental, cognitive, psychosocial, functional, and environmental (re)assessment. The care provider must,
  • Provide the patient and/or caregiver with a copy of the care plan
  • Ensure the electronic care plan is available and shared timely within and outside the billing practice to people involved in the patient’s care
  1. 24/7 Access & Continuity of Care – Provide 24/7 access to physicians or other qualified care providers or clinical staff and continuity of care with a designated member of the care team.
  2. Enhanced Communication Opportunities – Enhanced opportunities for the patient to communicate with the physician through not only telephone access, but also the use of secure messaging, Internet, or other non-face-to-face consultation methods.

HealthViewX Chronic Care Management solution features

HealthViewX Chronic Care Management solution has the following features that make the process simpler,

  • Inbuilt audio, video calling and messaging features – HealthViewX Chronic Care Management solution has inbuilt video and audio calling features. It helps in giving Chronic Care Management services to their patients. Secure messaging is also available through which the physicians and the patients can communicate.
  • Automated call log feature – After a call, care plan creation or any action related to CCM health services, the system automatically adds call logs. It reduces the physician’s manual effort is logging the call logs.
  • Preventive Care plans – HealthViewX solution supports care plans for the Chronic Care Management service for a patient. The physician can create a care plan depending on the patient’s health report. It helps in monitoring the patient’s vitals.
  • Chronic Care Management Analytics – Dashboards with intuitive charts and tables give complete analytics of the Chronic Care Management services. It provides a clear picture of the revenue perspective.
  • Consolidated Report – The physician can generate a consolidated report of the Chronic Care Management services given for a particular period. This makes it easy for the billing practitioner for getting the reimbursements.
  • HIPAA compliance – HealthViewX Chronic Care Management is HIPAA-compliant. It facilitates secure data exchange. The solution manages all patient-related documents securely.

HealthViewX Chronic Care Management solution has features that satisfy non-complex and complex CCM services. Medicare reimbursements for Chronic Care Management services increase the profits for community health centers. It also benefits patients with multiple chronic health conditions. To know more about our Chronic Care Management solution, schedule a demo with us.

 

Ten Advantages A Referral Management Software Should Provide

Referral Management Process in healthcare

Patient Referral Management in healthcare plays a vital role in treating patients. The physician identifies the need for a referral and sends it to the most relevant imaging center or specialty practice. A patient referral goes through the following steps,

  1. Referral Initiation – The referring physician identifies the need for a referral and initiates medical referrals.
  2. Insurance Pre-authorization – If the patient has an insurance coverage, the referring physician has to validate the same. The physician must do this to find the imaging center/specialist care practice comes under the patient’s insurance coverage.
  3. Finding the right provider – Depending on the treatment required, insurance coverage and patient’s convenience, the physician will narrow down the search and find the right receiving provider for the referral. Dr.Miller is a primary care physician. A patient visits his clinic complaining of chest pain. After the initial diagnosis, the physician refers him to a specialist for better treatment. The referring physician looks for the best cardiologist in the city. Considering the patient’s and specialist’s comfort, the referring physician initiates the referral.
  4. Sending out the referral – After finding the right provider, the referring physician shares the patient information and the diagnosis details with the receiving provider. The referral is sent via phone, fax, email, etc depending on the source, the receiving provider is comfortable in getting the referrals from.
  5. Following up with the referral – After the receiving provider receives the referral, the specialist may communicate with the referring physician for missing information. The physician should get things sorted and continue with the referral. The provider should schedule appointments with the patient and follow-up with the same. The specialist should give the referring physician timely updates on its progress.

The referral process is quite demanding for the physicians. Communicating and giving timely updates is not easy with the current workflow. Considering the complexity of referral networks, an effective Referral Management Software is the need of the hour.

Ten Advantages a Referral Management Software should Offer

The current process of referral is very time-consuming and tedious. It has no tracking system or cannot give periodic updates to the referring physician, patient, and the receiving provider. An updated electronic referral management system is required to streamline the referrals. It would enhance the overall experience of the PCP and patients, curb referral leakage and patient no-show rate. A Referral Management Software reduces manual intervention and makes the process simpler. It should offer benefits that will improve the physician-specialist equation, improve hospitals’ operational efficiency and increased revenue. The hospital must consider the following benefits before choosing a Referral Tracking Software,

  1. Multichannel Referral Consolidation – The receiving provider gets multi-channel referrals through sources like FAX, online forms, direct messaging, email, virtual print, direct walk-ins, etc. An Inbound Referral setup must have a Referral Management software that consolidates all referrals into a single queue. After the first step of multi-channel referral consolidation, it is easier to process the referrals.
  2. Reduced Referral Leakage – Referral Leakage is the single huge problem faced by high referral inbound setups. Referral leakage for any health system is between an average 55% to 65%. This, in turn, leads to high revenue loss. A Referral Management Software should ease the processing of several referrals on time. The Referral Tracking Software must help in finding the right specialist and also make sure that no tests are repeated. The Referral Management Software must make the patient documents available to both the referring and receiving physicians. Scheduling patient appointments and following up to see if the patient completed a referral visit will reduce the referral leakage.  
  3. Increased Operational Efficiency – It is the efficiency of hospital staff to manage referrals and check the progress of the treatment. A Referral Tracking Software must make the process simple by reducing the time spent on referral initiation. The software must make referral information available to both the referring and receiving physicians. Multi-channel referral consolidation, specialist smart search and increased referral tracking will improve operational efficiency.
  4. Automated Scheduling – The Referral Management Software must support an inbuilt scheduler. It schedules automated appointments with the patients and gives prompt reminders to the patient and the physician. This will never let a patient or physician miss their appointments thus reducing patient no-show rates. It helps the physician manage all their appointments on time. It thus leads to reduced patient referral leakage.
  5. Improved Referral Tracking – Manual referral tracking is a tedious job for hospitals. The referring physicians are least informed about the progress of the referral. This affects referral completion and referral loop closure. The Referral Management Software must always keep the referring physicians informed about the referral’s progress.
  6. Referral Completion – 25 to 50% of referring physicians do not know if their patients actually visit the specialist. Referral loop closure is very important for the referring physicians. Referral completion cannot happen when the referring physician is not informed about the progress of the referral.  The Referral Management Software must aid in referral completion by providing a secure platform for the receiving and referring physicians to communicate. Referral tracking and feedback for the referral from the receiving physician aid referral loop closure.
  7. Streamline the Flow of Referral – A Referral Management Software must streamline the flow of referral. It should consume less time for each step with minimal efforts of the patient, receiving and referring physicians.
  8. Enhanced communication between PCPs and specialists – The primary care physicians and the specialist find it difficult to communicate about referrals. The physicians may need to communicate for missing referral information, referral tracking or referral completion. The referral tracking software must have inbuilt messaging, audio and video calling features to enhance the communication between the primary care physicians and specialists.
  9. Improved Patient Satisfaction –  The patient faces difficulties in acting as a bridge between the referring and the receiving medical care physicians. This leads to patient dissatisfaction and patient referral leakage. Timely response to referrals, minimal diagnosis, and full insurance coverage improve patient’s experience with the referral. A Referral Tracking Software must cut down patient waiting time, improve the relationship between PCPs and specialists and the overall patient satisfaction. Improved patient experience directly results in increased revenue.
  10. Complete Referral Analytics – The Referral Management software should give complete data of the referrals flowing in and out of the network. Visualized data in the form of graphs, tables, charts, etc help in tracking the referrals in the pipeline. It helps in scheduling patient appointments with available documents. It gives a comprehensive data of the number of patients with various referral status and follow-up reminders for a day. The physician can customize the dashboard to show the preferred receiving physicians, the average revenue generated per patient referral, etc.

HealthViewX Patient Referral Management solution features

HealthViewX Patient Referral Management solution has features that best suit a hospitals’ Referral Management System.

  1. Seamless communication – HealthViewX solution has an inbuilt audio calling and messaging application which is secure and enables faster communication
  2. HIPAA compliant data security – The solution is HIPAA-compliant and offers secure data exchange. It supports almost all formats of files and keeps the patient documents safe.
  3. Referral history – The timeline view provides the history and current status of the referral. A status helps in knowing the referral progress.
  4. Data Analytics – A comprehensive dashboard helps to track the number of referrals in the queue and shows the number of referrals in different statuses. This helps in knowing how fast the referrals are getting closed.
  5. Report Consolidation – The data regarding the referrals and timeline view can be printed as a report anytime in pdf/excel form.

With HealthViewX Patient Referral Management solution in hand managing a referral life cycle is very easy. A 30-minute demo with our team will help you know how effective our solution can track and manage the referral life cycle. To know more schedule a demo with us.

 

Reference

https://www.mass.gov/files/documents/2016/08/uy/2011-hcctd-full.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3160594

How To Control Patient Referral Leakage In Your Referral Network?

          Health providers in a health system need patients to run their practice profitably. Be it a hospital, health network or private practice, healthcare providers rely on incoming referrals from other health providers and entities. Referrals generate revenue and improve patient retention rate. Providers tend to refer patients to specialists within the same hospital or health network. This is to retain them in the same hospital. A provider should consider factors such as personal relationships, quality outcomes, proximity, insurance coverage and patient preference before referring a patient. When a provider fails to consider these, patient referral leakage is bound to happen.

Patient Referral Leakage

Patient Referral Leakage happens when healthcare providers refer patients out-of-network. Accordingly, patient leakage is sometimes known as network leakage or referral leakage. The following definitions will help in better understanding of patient leakage,

  1. In-Network – In-network refers to medical care within a network of doctors, hospitals, and other health providers who have a contract with a health insurance company. Inside the network, patients seek medical care only from those providers who are under the terms of the health insurance. In-network care is cheaper due to discounted rates that a health insurance company has negotiated ahead of time with the various health networks.
  2. Out-of-Network – Out-of-network refers to patients looking to get medical care outside their current health network. This means that the patients seek care from out-of-network providers who cover their health insurance. Health providers refer patients seeking advanced treatment out-of-network. This is the main reason for patient leakage.

Why does patient referral leakage happen?

Sometimes patient referral leakage is unavoidable. When patients need medical care that is unavailable in their network, the health provider must understand the patient’s needs. The health provider must refer the patient to a specialist or an imaging center depending on the need.

However, there are occasions where in-network providers may refer patients to out-of-network providers on purpose.

  1. Provider’s Repute – Sometimes, a health provider may refer their patients out-of-network to another provider who is more reputable in that specialty. This could be because the current health network has not employed a reputable specialist. The provider must make sure that a patient gets the best treatment possible.
  2. Unaware of Providers in their network – Health providers who have just joined a health network or are a part joint ventures, acquisitions do not know all their specialists. This causes confusion and the health providers refer the patient out-of-network. When a health system fails to make it easy for health providers to refer within the network, patient leakage is inevitable.
  3. Patient’s Choice – When certain treatment or care is not available within a network then it is up to the provider to refer the patient out-of-network. The health provider may recommend a next best course of treatment and the provider to consult for advanced treatment. Patients do tend to take the provider’s advice but it is up to the patient. This is why certain amounts of patient leakage will always exist. If the patient decides to move out of the practice due to unavoidable reasons then referral leakage becomes inevitable.

Why should it be curbed?

  • Patient’s Benefit – The patient may need immediate care and attention. So processing and closing it at the earliest will be the best for the patient. Patient leakage leads to open patient referral loop which will affect the patient’s health.
  • Patient’s Experience – A patient moves out-of-network due to many reasons. Primarily it is because the patient is not satisfied with the medical care provided in the current health system. Patient’s bad experience has a direct effect on hospital’s revenue, the number of incoming referrals, patient crowd, etc. In order to give efficient care to the patients, a health system must prevent patient leakage.
  • Missed Revenue and Reimbursement opportunities – The main problem with patient leakage is the missed revenue opportunities for health systems. These organizations miss out on reimbursement for medical services that they had provided earlier when patient leakage occurs. This applies to healthcare systems that adopt value-based care or payment models such as accountable care organizations (ACOs).
  • Failed relationships with healthcare providers and patients – Patient leakage results in failed relationships with healthcare providers and patients. Many health systems have spent resources on building clinical alignment with their referral network. Unfortunately, when patients go out of the system providers lose their trusted receiving providers.

How to tackle Patient Referral Leakage?

  • Employing right providers – Organizations can cut down patient leakage by employing respected, experienced, and well-regarded providers that they. This will cut down the number of patients who voluntarily go out-of-network. This is because they will find the right provider in their network.
  • Clear communication between physicians and patients – Clear communication between providers and patients is key to creating a positive patient experience and engagement. A health system can decide to give patients control of their own health by implementing an e-consult software. It should allow patients to schedule their own appointments, talk to providers online, order prescriptions, etc.
  • Being transparent in all aspects – The health system must be transparent about prices and pricing structure with the patients. Healthcare providers should give upfront estimates of costs and detailed end-of-care financial statements. Quality metrics is the other part that health networks must make readily available to the patients. It includes patient outcomes, patient satisfaction scores, physician reviews, etc. Ease of use and timely access to best care are crucial aspects of the patient experience. In a health system, it is important for a patient to receive medical care easily and in a timely manner.

How can HealthViewX Referral Management solution help?

Information Technology is transforming healthcare to a great extent. Patient referral leakage never happens with the help of a software application like HealthViewX. HealthViewX Patient Referral Management solution simplifies the referral process by the following steps,

  1. Referral Initiation – The patient demographics and diagnosis required are already in the application. The referral coordinator can create the referral through a simple three-step form which includes health insurance pre-authorization, finding the right receiving provider with the help of  “smart search”, etc. After finding the receiving provider, the referral coordinator refers the patient. When the receiving provider receives the referral, the provider will get notified of the referral.
  2. Referral status and timeline view – With the help of a referral status, the referring provider can get to know what stage the referral is. A timeline view shows a history of stages through which the referral has progressed.
  3. Referral and timeline view reports – The health provider can generate the timeline view and referral analytics data as a report in any form.
  4. Referral closure and feedback – The referring provider can close the referral when it gets completed. The receiving provider and the patient can give a feedback on the referral process to the referring provider. Thus the referring provider can make it easy for the other the next time.

HealthViewX Patient Referral Management solution smooths the referral process and reduces the burden of the referring and the receiving ends. Referral Management software cuts down patient referral leakage to a considerable number. Do you want to know more about HealthViewX Patient Referral Management solution? Schedule a demo with us.

 

Remote Care And How Chronic Care Management Simplifies It

         Healthcare industry of the US has introduced many technologies to give the best care to all irrespective of their place, accessibility, etc. Remote Care to patients is the latest healthcare technology. It enables monitoring of patients’ health outside conventional clinical settings. This may increase access to care and cut down the healthcare delivery costs. Hospitals offer Telehealth services as a part of Remote Care. This includes,

  1. Virtual Consultation – It is a virtual visit that takes place between the patient and the physician. It takes place through audio or video calls. It is effective for common problems like flu, acne, fever, etc. It reduces the patient’s traveling cost and provides better access to quality care.
  2. Remote Health Monitoring – Patient Health Monitoring is the latest technology in the healthcare industry. Patient physiological data like blood pressure, blood sugar, heart rate, etc can be measured by external devices. It can be a Fitbit, apple watch, etc that can communicate with the system in the hospital. It will help the physician to always keep an eye on their patients’ vitals and prescribe telemedicine and preventive care plans.
  3. Chronic Care Management – Chronic Care Management is non-face-to-face care provided to patients with multiple chronic conditions. Medicare reimburses a certain amount for the Chronic Care Management services given by the hospital. Chronic Care Management is most administered through audio calls.

As Chronic Care Management services have reimbursements, physicians must consider administering CCM to the eligible patients. Medicare provides Chronic Care Management services for patients with multiple (two or more) chronic conditions

  • Expected to last at least 12 months or until the death of the patient.
  • Places the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline.

CCM Service Summary

The following are steps through which a Chronic Care Management service is furnished,

  1. Initiating Visit –  Initiation during an Annual Wellness Visit (AWV), Initial Preventive Physical Examination (IPPE) or face-to-face E/M visit for new patients or patients not seen within one year prior to the commencement of Chronic Care Management services.
  2. Structured Recording of Patient Information Using Certified EHR Technology –  Structured recording of demographics, problems, medications, and medication allergies using certified EHR technology.
  3. 24/7 Access & Continuity of Care – Provide 24/7 access to physicians or other qualified healthcare professionals or clinical staff and continuity of care with a designated member of the care team.
  4. Comprehensive Care Plan – Creation, revision, and/or monitoring of an electronic person-centered care plan.
  5. Enhanced Communication Opportunities – Enhanced opportunities for the patient to communicate with the physician through not only telephone access, but also the use of secure messaging, Internet, or other non-face-to-face consultation methods.

Eligibility Criteria for Physicians

Physicians and the following non-physician practitioners may bill CCM services:

  • Certified Nurse Midwives
  • Clinical Nurse Specialists
  • Nurse Practitioners
  • Physician Assistants

HealthViewX Chronic Care Management solution features

HealthViewX Chronic Care Management solution has the following features that make the process simpler,

  • Inbuilt audio, video calling and messaging features – HealthViewX Chronic Care Management solution has inbuilt video and audio calling features. It helps in giving Chronic Care Management services to their patients. Secure messaging is also available through which the physicians and the patients can communicate.
  • Automated call log feature – After a patient call, care plan creation or any action related to Chronic Care Management services, call logs are added to the patient. It reduces the physician’s manual effort is logging the call logs.
  • Preventive Care plans – HealthViewX solution supports care plans for the Chronic Care Management service for a patient. The physician can create a care plan depending on the patient’s health report. It helps in monitoring the patient’s vitals.
  • Chronic Care Management Analytics – Dashboards with intuitive charts and tables give complete analytics of the Chronic Care Management services. It provides a clear picture from the revenue perspective.
  • Consolidated Report – The physician can generate a consolidated report of the Chronic Care Management services given for a particular period. This makes it easy for the billing practitioner for getting the reimbursements.
  • HIPAA compliance – HealthViewX Chronic Care Management is HIPAA-compliant. It facilitates secure data exchange. All patient-related documents are managed securely.

HealthViewX Chronic Care Management solution is on par with the current requirements. Remote care is the easiest and the cheapest way to treat your patients. Medicare provides reimbursements for Chronic Care Management which makes it the best way to give care to patients from the remote. To know more about our Chronic Care Management solution, schedule a demo with us.